Intoxication with massive doses of amlodipine and candesartan requiring venoarterial extracorporeal membrane oxygenation

Author:

Yusuke Minagawa1ORCID,Hidetoshi Yamana2,Yusuke Tsutsumi2ORCID,Koji Ishigami2,Masahito Togo2,Susumu Yasuda2,Takayuki Ogura1ORCID

Affiliation:

1. Department of Emergency and Critical Care Medicine Saiseikai Utsunomiya Hospital Utsunomiya Japan

2. Department of Emergency Medicine National Hospital Organization Mito Medical Center Mito Japan

Abstract

AbstractBackgroundCalcium channel blockers and angiotensin II receptor blockers are commonly prescribed to treat hypertension. Massive overdoses can cause both distributive and cardiogenic shock because of their effects on vascular smooth muscles and severe myocardial depression.Case PresentationWe present the case of a 46‐year‐old man who was brought to our emergency department after ingesting 1210 mg amlodipine and 936 mg candesartan. The patient's hemodynamic status deteriorated despite treatment with vasopressors, calcium gluconate, and hyperinsulinemia‐euglycemia therapy with mechanical ventilation. Venoarterial extracorporeal membrane oxygenation was initiated for refractory shock. The patient was weaned off extracorporeal membrane oxygenation on day 5 and discharged on day 18 of hospitalization.ConclusionWhen medical therapies are ineffective, aggressive venoarterial extracorporeal membrane oxygenation should be considered for the management of refractory shock in the setting of calcium channel blocker with angiotensin II receptor blocker overdose.

Publisher

Wiley

Subject

Industrial and Manufacturing Engineering,Materials Science (miscellaneous),Business and International Management

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